Think we have discussed the fact that there have been no studies on SDD and SND yet. And what did we say the reason was?
I think the reason was because there weren’t enough patients in programs.
When we say no studies, we mean gold standard double blind clinical trials. Dialysis doesn’t lend itself to that kind of study when it comes to studying the dialysis itself. There have been observational studies, but so far the samples sizes have been relatively small, and the studies of relatively short duration.
That’s an overstatement… :roll:
Long term studies no, but significant research yes. There’s living proof already of all those patients doing home dialysis that their health has improved greatly. All we need now is a few more years to go to clarify the findings…
There are studies being conducted now.
There are literally hundreds of studies about short daily and nocturnal hemo, from all around the world. In fact, we have a bibliography of them that you can download, at http://www.homedialysis.org/v1/resources/pdfs/LITT_update_3-2-05_.pdf.
Neither treatment is as “new” as you might think–home hemo was originally done at night back in the early 1960s, and Dr. John DePalma first tried short daily treatments (in-center) at probably around that time as well. (He had excellent results, by the way, but the reimbursement wasn’t there and he had to stop).
There are even small, non-random studies now that demonstrate significantly better survival with short daily treatments than with conventional in-center treatments. (Comparable studies have not yet been reported on nocturnal dialysis–but the best outcomes in the world have been reported in Tassin, France, by Dr. Bernard Charra, and that center has been doing nocturnal dialysis for decades).
We just today uploaded a new slide presentation by Dr. Mike Rocco, who is a researcher working on the pair of NIH Frequent Hemodialysis Network studies http://www.homedialysis.org/v1/rotating/1105topicofthemonth.shtml. This talk, which he gave at the NKF Spring Clinicals meeting in Chicago, goes through the reasons why a random, controlled study is needed, even though there have been multiple small studies. You can see it at: http://www.homedialysis.org/v1/resources/ppt-files/NocturnalHDNKF3a.ppt.htm.
The other potential source of lots of data on the benefits of short daily and nocturnal home hemo is HR 5321 - Access to Better Choice in Dialysis Act of 2006, which would pay for a pilot study that would enroll up to 10,000 patients for 5 years and collect outcomes and cost data. This bill can only pass if it gets sponsors, so please contact your representative and ask him or her to sponsor the bill. You can do that at: http://capwiz.com/meiresearch/issues/alert/?alertid=8771121&type=CO.